Duration Of Breastfeeding Research Articles

Differences in Breastfeeding Duration by Maternal HIV Status: A Pooled Analysis of Nationally Representative Surveys in Sub-Saharan Africa.

Breastfeeding improves child survival but is a source of mother-to-child HIV transmission among women with unsuppressed HIV infection. Estimated HIV incidence in children is sensitive to breastfeeding duration among mothers living with HIV (MLHIV). Breastfeeding duration may vary according to maternal HIV status. Sub-Saharan Africa. We analyzed pooled data from nationally representative household surveys conducted during 2003-2019 that included HIV testing and elicited breastfeeding practices. We fitted survival models of breastfeeding duration by country, year, and maternal HIV status for 4 sub-Saharan African regions (Eastern, Central, Southern, and Western). Data were obtained from 65 surveys in 31 countries. In 2010, breastfeeding in the first month of life ("initial breastfeeding") among MLHIV ranged from 69.1% (95% credible interval: 68-79.9) in Southern Africa to 93.4% (92.7-98.0) in Western Africa. Median breastfeeding duration among MLHIV was the shortest in Southern Africa at 15.6 (14.2-16.3) months and the longest in Eastern Africa at 22.0 (21.7-22.5) months. By comparison, HIV-negative mothers were more likely to breastfeed initially (91.0%-98.7% across regions) and for longer duration (median 18.3-24.6 months across regions). Initial breastfeeding and median breastfeeding duration decreased during 2005-2015 in most regions and did not increase in any region regardless of maternal HIV status. MLHIV in sub-Saharan Africa are less likely to breastfeed initially and stop breastfeeding sooner than HIV-negative mothers. Since 2020, UNAIDS-supported HIV estimates have accounted for this shorter breastfeeding exposure among HIV-exposed children. MLHIV need support to enable optimal breastfeeding practices and to adhere to antiretroviral therapy for HIV treatment and prevention of postnatal mother-to-child transmission.

Interpretable prediction of acute respiratory infection disease among under-five children in Ethiopia using ensemble machine learning and Shapley additive explanations (SHAP).

Although the prevalence of childhood illnesses has significantly decreased, acute respiratory infections continue to be the leading cause of death and disease among children in low- and middle-income countries. Seven percent of children under five experienced symptoms in the two weeks preceding the Ethiopian demographic and health survey. Hence, this study aimed to identify interpretable predicting factors of acute respiratory infection disease among under-five children in Ethiopia using machine learning analysis techniques. Secondary data analysis was performed using 2016 Ethiopian demographic and health survey data. Data were extracted using STATA and imported into Jupyter Notebook for further analysis. The presence of acute respiratory infection in a child under the age of 5 was the outcome variable, categorized as yes and no. Five ensemble boosting machine learning algorithms such as adaptive boosting (AdaBoost), extreme gradient boosting (XGBoost), Gradient Boost, CatBoost, and light gradient-boosting machine (LightGBM) were employed on a total sample of 10,641 children under the age of 5. The Shapley additive explanations technique was used to identify the important features and effects of each feature driving the prediction. The XGBoost model achieved an accuracy of 79.3%, an F1 score of 78.4%, a recall of 78.3%, a precision of 81.7%, and a receiver operating curve area under the curve of 86.1% after model optimization. Child age (month), history of diarrhea, number of living children, duration of breastfeeding, and mother's occupation were the top predicting factors of acute respiratory infection among children under the age of 5 in Ethiopia. The XGBoost classifier was the best predictive model with improved performance, and predicting factors of acute respiratory infection were identified with the help of the Shapely additive explanation. The findings of this study can help policymakers and stakeholders understand the decision-making process for acute respiratory infection prevention among under-five children in Ethiopia.

Association between parities and duration of breastfeeding and the severity of coronary artery disease in women above 30 years old age (A pilot study).

The prevalence and mortality of CVD in women increase over time. We conducted this research to evaluate the severity of coronary artery disease with the number of live births and breastfeeding duration. Patients aged 30-50 years old with positive exercise tests or evidence of cardiac ischemia who were candidates for coronary angiography were included. All the participants had at least one child. Syntax score was used to evaluate the severity of coronary arteries. Mean number of children was 3.72±1.85, in those patients with <2 live births no one had a syntax score≥1, but in the>5 live births group most patients had a syntax score≥1. In patients with zero syntax score, it was estimated as 4.91±39.7; in patients with 1≤ syntax score, it was 4.48±7.29 (P =0.76). Among patients with > 5 birth lives, those with higher syntax scores had older ages (P=0.497). After adjusting age, the association between live births and syntax score became non-significant (P=0.850). By increasing the number of live births >5, the severity of coronary artery disease, increases. However, this association was not significant after adjusting the age of patients.

Development of a Protocol for the Direct Breastfeeding of Premature Infants in Neonatal Intensive Care Units.

This study aimed to develop a direct breastfeeding protocol for premature infants admitted to neonatal intensive care units (NICUs) and investigate its efficacy. Direct breastfeeding increases the amount and duration of breastfeeding. However, NICUs have low direct feeding rates owing to medical staff anxiety, lack of knowledge and experience, and fear of overwork. Accordingly, this study developed a protocol for direct breastfeeding in the NICU and evaluated its effect. The protocol was developed through a literature review, expert validation, and preliminary investigation. Its application effects were identified using a nonexperimental, evidence-based research design targeting premature infants, their mothers, and NICU nurses. The protocol comprised 5 areas and 23 items. Application of the protocol resulted in continuous weight gain of the infants and increased self-efficacy in the mothers' direct breastfeeding ( t = 3.219, P = .004). Significant increases were noted in NICU nurses' direct breastfeeding activities ( t = 3.93, P < .001), breastfeeding rates in the NICU ( P = .037), and direct breastfeeding rates ( P = .007). Results underscore the value of an evidence-based protocol for improving breastfeeding rates in premature infants. This study highlights the need for continuous nursing education on protocol applications and human resource support.

Breastfeeding and risk of neurodevelopmental disorders: a meta-analysis

This meta-analysis aimed to investigate the association between breastfeeding and the risk of neurodevelopmental disorders, specifically autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). A comprehensive search of the PubMed, Web of Science, and Scopus databases yielded ten studies published between 2006 and 2018. The analysis utilized a random-effects model, with the log odds ratio as the outcome measure. Heterogeneity was assessed using the Q test and the I² statistic, and potential outliers were identified using studentized residuals and Cook\&amp;apos;s distances. The findings of the included studies revealed that breastfeeding was associated with a reduced risk of both ASD and ADHD. Children who were breastfed demonstrated a 30% lower risk of ASD (pooled log odds ratio: -0.3266, 95% CI: -1.2252 to 0.5721) and a 27% lower risk of ADHD (pooled log odds ratio: -0.3266, 95% CI: -1.2252 to 0.5721) than did those who were not breastfed. Subgroup analyses, considering disease type, study design, and study quality, supported these findings. In conclusion, this meta-analysis provided the evidence that breastfeeding, whether exclusive or mixed, might have a protective effect against neurodevelopmental disorders, namely, ASD and ADHD. However, the duration of breastfeeding did not significantly impact the development of ADHD. Further research is necessary to better understand the underlying mechanisms involved and to establish more robust conclusions.

Black Families Who Choose Long-Term Breastfeeding.

Black families face disproportionate rates of poor health outcomes, including low rates of breastfeeding initiation and duration. Some Black mothers make the decision to breastfeed their child beyond infancy and report positive experiences. Understanding their backgrounds, motivations, and characteristics of their breastfeeding experiences may provide insight into what factors facilitate achievement of long-term breastfeeding for Black mothers. Surveys were deployed through a variety of methods including social media and emails to organizations that work with breastfeeding families. Descriptive statistics were used to analyze survey data and the open-ended question was analyzed using a word cloud program. Surveys were completed by 194 eligible mothers. Participants had a mean age of 31 years (range: 19-50). Mean breastfeeding duration of their currently breastfed and youngest child was 21 months (median: 19.5, range: 12-57). Primary reasons for breastfeeding beyond infancy included child wants to cuddle (28.9%) and child is tired (24.7%). Fifty-seven percent of participants reported that their child breastfed three to six times per day and 57.2% reported that their child woke up at least two times per night to feed. Nurses are uniquely positioned to provide anticipatory guidance, resources, and support to breastfeeding parents. Just over half of the mothers in this study had not planned to breastfeed beyond 12 months at the start of their lactation journey. Nurses who work with breastfeeding families could be instrumental in providing resources, support, and tangible assistance for families who may consider breastfeeding beyond 1 year.

Effects of probiotics on gastrointestinal symptoms, anthropometric measurements, and breastfeeding duration in infants with colic: a randomized control trial.

Infantile colic has a multifactorial etiology. Recent studies have suggested that probiotics may be effective in its management. This study was carried out to evaluate the effect of the Actiregularis strain (5×106 cfu\ml) included in maternal nutrition on gastrointestinal problems, growth development, and breastfeeding outcomes in infantile colic. The study was a randomized controlled trial conducted in the neonatal outpatient clinic of a training and research hospital in Turkey. A probiotic drink containing the Actiregularis (5×106 cfu\ml) strain was added to the diet of mothers in the probiotics group once daily for 15 consecutive days. Data were collected for each infant's 0th (birth), 1st, 4th, and 6th months. Infants whose mothers were administered Actiregularis for 15 days had decreased crying intensity (P = 0.000). When the difference in breastfeeding rates between the groups was significant at the 4th and 6th months (P = 0.044; P = 0.035). There was no difference in anthropometric values except the babies' weights at the 6th month. (P < 0.001). Infants treated with Actiregularis, which was added to their mothers' diet for 15 days, showed a decrease in the frequency of crying, and the difference in breastfeeding rates between the groups was significant at the 4th and 6th months. There was no difference in anthropometric values except the babies' weights at the 6th month. NCT04374955 (https://clinicaltrials.gov/ct2/show/).

Correlação entre peso ao nascer, amamentação e índice de massa corporal aos seis anos de idade

Abstract Objectives: to estimate the correlation between birth weight, breastfeeding, and body mass index in six-year-old children in the city of Palhoça/SC, Brazil. Methods: a cross-sectional study involving 502 children. Data were collected through interviews with mothers at home and anthropometric assessments at schools. The child’s current body mass index was the dependent variable. The independent variables were birth weight, breastfeeding duration, and exclusive breastfeeding duration. Correlations among variables were estimated using Pearson’s correlation coefficient and respective coefficients of determination. Multiple linear regression analysis was performed to observe the independence among the variables. Results: birth weight and body mass index at six years of age showed a statistically significant positive correlation (r= 0.115; p=0.008). Breastfeeding duration was not correlated (r= -0.018; p=0.683). The duration of exclusive breastfeeding showed a statistically significant negative correlation (r= -0.103; p=0.018). However, multiple linear regression analysis showed an independent and significant positive correlation only between birth weight and body mass index at six years of age (r= 0.142; p= 0.003). Conclusion: higher birth weight was significantly and independently positively correlated with increased body mass index at six years of age.

Bedsharing among breastfeeding physicians: Results of a nationwide survey.

Bedsharing is common but advised against by the American Academy of Pediatrics. It is unknown if breastfeeding physicians bedshare more or less than the general population. To determine the prevalence of bedsharing among physicians, their reasons for bedsharing or not, and whether bedsharing was associated with a longer duration of breastfeeding. An online survey was adapted from surveys administered by the Centers for Disease Control and Prevention. The survey was administered to physicians and medical students who birthed children from October 2020 through August 2021. Respondents were asked to report on a singleton birth, and questions centered around sleep practices and breastfeeding. Survival analysis was used to examine the association between bedsharing and breastfeeding duration. Of 546 respondents with bedsharing data, 68% reported some history of bedsharing, and 77% were in specialties that involved caring for pregnant people and/or infants. Those who bedshared breastfed an average of four months longer than those who never bedshared (18.08 versus 14.08 months p<0.001). The adjusted risk of breastfeeding cessation was markedly lower for those who bedshared compared to those who did not (Hazard Ratio 0.57, 95% Confidence Interval 0.45, 0.71). The primary reason for bedsharing was to breastfeed (73%); the primary reason for not bedsharing was safety concerns (92%). Among those who bedshared (n = 373), 52% did not inform their child's healthcare provider. Bedsharing is common among our sample of mainly breastfeeding physicians, including those who care for pregnant people and/or infants. It is also associated with a longer duration of breastfeeding, which has implications for population health. Practicing bedsharing implies cognitive dissidence and may affect how physicians counsel about bedsharing. Additionally, lack of disclosure of bedsharing practices has implications for practical guidance about having open non-judgmental conversations and may be a missed opportunity to counsel on bedsharing safety.

Is the impact of paid maternity leave policy on the prevalence of childhood diarrhoea mediated by breastfeeding duration? A causal mediation analysis using quasi-experimental evidence from 38 low-income and middle-income countries

ObjectivesQuasi-experimental evidence suggests that extending the duration of legislated paid maternity leave is associated with lower prevalence of childhood diarrhoea in low-income and middle-income countries (LMICs). This could be due...

Association between sleep duration and latency, nocturnal awakenings, and body mass index among infants.

To investigate the association between sleep duration, nocturnal awakenings, and sleep latency with body mass index (BMI) at six and 12 months of age. 179 children from a birth cohort were enrolled. At six and 12 months of age, anthropometric data were obtained using standardized techniques and infants' mothers answered the Brief Infant Sleep Questionnaire for sleep data. The association of BMI with the independent variables (sleep duration, latency, and nocturnal awakenings) was assessed by linear regression models. Analyses were adjusted for potential confounders and a p-value<0.05 was adopted to define statistical significance. For each additional hour of sleep duration, BMI was reduced by 0.15 kg/m² (95% confidence interval [CI] -0.28; -0.01; p=0.03) and each additional minute of sleep latency increased BMI by 0.01 kg/m² (95%CI -0.00; 0.03; p=0.02). These associations were independent of gestational age, child sex, birth weight, duration of exclusive breastfeeding, smoking during pregnancy, and mother's BMI, education, and marital status. Nocturnal awakenings showed no association with the outcome. Our findings suggest that sleep duration and sleep latency time are associated with BMI in the first year of life. Insights into the influence of sleep early in life on weight status may be helpful to complement future nutritional recommendations and prevent and treat obesity.

Socioeconomic and regional patterns of child nutritional inequality between tribal and non-tribal communities in India: An analysis based on National Family Health Survey 5 (2019–21)

Background: Despite India’s impressive economic growth and the implementation of a large-scale antimalnutrition program, the country continues to face the highest levels of child malnutrition globally. Among the affected children, half of those under the age of 3 years, in both tribal and nontribal populations, are underweight, while a third of the wealthiest children experience overnutrition. Economic inequality plays a significant role in contributing to malnutrition in both tribal and nontribal communities. Therefore, utilizing data from the fifth round of the National Family Health Survey (2019–21), the present study aims to examine the socioeconomic disparities in childhood malnutrition across all 640 districts of India, with a specific focus on tribal and nontribal populations. Methods: The analysis includes a sample of children aged 0 to 59 months from tribal and nontribal communities. Sociodemographic, personal, clinical, and environmental factors are considered as independent variables. The outcomes of interest include stunting, wasting, and underweight, which are assessed using binary variables. Linear modeling are used to determine the associations between the independent variables and child undernutrition. Results: The study reported a negative Z value (−4.763), indicating greater overall inequality in the tribal population compared to the nontribal population. In terms of odds ratios, females had lower odds of being underweight in both tribal and nontribal populations. Children aged 1 to 2 years had higher odds of being underweight compared to those aged 1 year. The duration of breastfeeding showed varying associations, with breastfeeding for 7 to 12 months increased the risk of underweight in nontribal areas, while longer durations (13–24 and &gt;24 months) were associated with higher chances of wasting in nontribal areas. Higher maternal age at first birth, higher education levels, and sufficient antenatal care visits were protective factors against underweight in both populations. A higher wealth index consistently correlated with reduced odds of underweight in both tribal and nontribal populations. Institutional delivery was associated with higher odds of underweight in tribal areas but lower odds in nontribal areas. Conclusion: The study concludes that in order to address the socioeconomic disparities contributing to stunting, wasting, and undernutrition among tribal populations, targeted interventions are required. These interventions should focus on improving access to education, healthcare, and economic opportunities, particularly among tribal communities. Additionally, policies should aim to reduce income inequality and promote inclusive economic development, ensuring that the benefits of progress are equitably distributed across all population groups. By addressing these socioeconomic factors, it is possible to improve the nutritional status and overall well-being of tribal populations.

Breastfeeding Experiences of Midwife Mothers and Barriers to Their Breastfeeding

Introduction: Midwives are at the forefront of the breastfeeding success of mothers, but the breastfeeding experiences of midwives who are mothers are unknown. Aim: This study was planned to determine the breastfeeding experiences of midwife mothers and the barriers to their breastfeeding. Materials and Methods: The study used a cross-sectional and descriptive design. A total of 177 midwives who had breastfeeding experience were included in the study. Results: The mean age of the midwife mothers was 39.71 ± 7.17 years and 53.1% had 2 children. The first breastfeeding time was 152.76 ± 471.97 minutes, the duration of breastfeeding was 14.88 ± 9.87 months, the duration of exclusive breastfeeding was 4.43 ± 1.65 months, and the duration of maternity leave was 6.16 ± 6.30 months. It was determined that 38.4% gave pre-lacteal feeding. It was found that some of the participants could not breastfeed because 34.5% of them did not have enough milk, 28.2% took short maternity leave, 26.6% had a busy work schedule, 24.9% had long working hours, 22.6% did not have a suitable place to express milk, 18.6% did not have enough time, and 10.7% were concerned about COVID-19 transmission. A statistically significant correlation was found between exclusive breastfeeding in the first 6 months and breastfeeding up to the age of 2 and pre-lacteal feeding, time of going back to work after maternity leave, psychological status, and sleep status (p

Bebek Cinsiyetinin Annelerin Emzirme Tutumları ve Süreleri Üzerindeki Etkisinin Araştırılması: Kesitsel bir Çalışma

The aim of this study was to examine the effect of infant gender on mothers' breastfeeding attitudes and duration in Turkey. This cross-sectional study was conducted with women (n:386) each of whom had a child between 1 and 36 months old and applied to family health centers in 2022. Data were collected using the “Information Form”’ and the “Iowa Infant Feeding Scale (IIFAS)”. Data were analyzed by descriptive statistics, t-test. The study was carried out according to STROBE. The mothers' IIFAS mean score was 63.54±7.01. The IIFAS score of mothers with girls was 63.31 (SD: 7.04), with boys were 64.56 (SD: 6.87), and the difference between them was not statistically significant (t: -1.602, p&gt;0.05). The mean duration of breastfeeding for girls was 14.36 + 7.52 months, and for boys were 15.26 + 7.62 months, and the difference between them was not significant (t: -1.215, p&gt;0.05). We concluded that there was no disparity in the duration of exclusive breastfeeding and total breastfeeding for the children of both sexes of the mothers in the study. In addition, it was determined that mothers' attitudes toward breastfeeding were positive.

Sustainable Breastfeeding: A State-of-the Art Review.

Disparities in breastfeeding rates and exclusivity exist across regions and countries despite multifaceted breastfeeding promotion efforts in recent decades. Markets for artificial milk formula continue to grow as its substitution for breastfeeding is common. A new approach is needed for breastfeeding promotion strategies. This state-of-the-art review aimed to describe the implications of not-breastfeeding on the environment within the context of food system sustainability. A total of 19 peer-reviewed articles within a 20-year timeframe were included in this review. Authors searched five databases for articles including Science Direct, GreenFILE, Springer Link, ProQuest, and PubMed. The demand for artificial milk formula production as a replacement for breastfeeding results in increased greenhouse gas emissions, water pollution, and waste, thereby aggravating problems with freshwater scarcity. A short duration of breastfeeding and limited exclusivity have been associated with close birth spacing and contributing to global population growth. Breastfeeding is a healthy, sustainable diet, and a culturally acceptable first food. It advances health equity and food security. Exclusive breastfeeding for the first 6 months of life can be promoted with emphasis on total carbon footprint reduction, prevention of waterway degradation, and natural birth spacing, thereby sustaining food systems at large. It is important to reform food, nutrition, and environmental policies to protect exclusive breastfeeding while decarbonizing artificial milk formula production. More research is needed to provide directions for new breastfeeding promotion strategies connecting breastfeeding with environmental stewardship.

Introduction of Breast Milk Substitutes During the First 3 Days of Life: Results of the Mexican National Survey of Demographic Dynamics, 2018.

Background: The introduction of foods or fluids other than breast milk in the first few days after birth interferes with the establishment of breastfeeding. This study aimed to investigate the association of formula introduction during the first 3 days of life with maternal sociodemographic characteristics, hospital practices, and breastfeeding duration. Materials and Methods: Information from the National Survey of Demographic Dynamics, 2018, which includes 17,686 mother-baby pairs was analyzed. Mother-baby pairs were classified into categories according to breastfeeding duration: <5 months and ≥5 months. Statistical methods and a machine learning algorithm (Bayesian network, BN) were used to analyze the data. Results: In general, 3,720 (21%) mothers reported introducing formula during the first 3 days of life. A lower education level, lower sociodemographic stratum, living in a rural area, and considering oneself indigenous were factors associated with not introducing formula during the first 3 days of life. A total of 5,168 (29.2%) mother-baby pairs practiced breastfeeding for <5 months, and 12,518 (70.8%) for ≥5 months. Almost twice as many mothers who practiced breastfeeding for <5 months introduced formula during the first 3 days of life (31.7%) compared with those who practiced breastfeeding for ≥5 months (16.6%). The BN model can sufficiently predict cases with a breastfeeding duration ≥5 months (precision-recall curve area = 0.792). Discussion: Introducing formula during the first 3 days of life was associated with a shorter breastfeeding duration. BN analysis showed a probabilistic dependency between the type of delivery and variables associated with the establishment of breastfeeding.

Neonatal hypernatremic dehydration in breastfed neonates: a prospective study unmasking the influences of breastfeeding practices and early weight monitoring

Introduction: Hypernatremic dehydration in neonates is an uncommon but serious reason for re-hospitalization, especially in exclusively breastfed neonates. The aim was to study the incidence, associated maternal and neonatal characteristics and risk factors, and presenting features of neonatal hypernatremic dehydration (NHD). Methods: A prospective study design was employed to enroll full-term newborns admitted with serum sodium concentrations of ≥145 mEq/L from April 2022 to March 2023 at a tertiary care rural hospital. Maternal and neonatal characteristics and breastfeeding practices of these mother-baby pairs were recorded and observed. Healthy control for every mother-baby pair was taken. Ethical clearance and informed consent were obtained from mothers. Result: 34 newborns out of total 672 NICU admissions were admitted due to NHD, with an incidence of 4.7%. Primiparous mothers were 23 (67.6%) in the cases and 10 (29.4%) in the control group (p = 0.0017). Disparity in maternal breastfeeding practices of cases, such as delayed initiation time 2.3 h vs. 1.27 h (p < 0.0001), less frequency of breastfeeding 6.5 times vs. 9.3 times (p < 0.0001), and duration of breastfeeding sessions 23.3 min vs. 32 min (p = 0.0014) respectively in cases and controls were found to be potential contributing factors. 61.7% of mothers had breast issues in the cases and 17.6% in the control group (p = 0.0002) with average LATCH score of 4.29 in cases as compared to 8.08 in controls (p < 0.0001) at time of baby’s admission to NICU. The average neonatal age at presentation was six days and average weight loss was 11.4% in cases vs. 2.8% in controls (p < 0.0001). The main presenting features were excessive weight loss 30 (88.2%), lethargy 20 (58.8%), jaundice 18 (52.9%) and fever 14 (41.1%). Conclusion: Neonatal hypernatremic dehydration (NHD) poses a significant clinical challenge, particularly in full-term, exclusively breastfed healthy neonates. We found an incidence of 4.7%. Delayed initiation of breastfeeding, inadequate breastfeeding techniques, and maternal breast-related issues were significant contributors to NHD. Primiparous mothers were found to be at higher risk, emphasizing the need for targeted breastfeeding education and support for primiparous mothers. The study reaffirmed the critical role of frequent and effective duration of breastfeeding and daily weight monitoring for preventing NHD.

Production of Breast Milk in Pregnant Women with and without Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) is a health disorder associated with an increased risk of type 2 diabetes mellitus (T2DM) in both mother and baby. Breastfeeding is one way that mothers do to reduce this risk. However, research results showed that the duration of breastfeeding in mothers with GDM was shorter compared to non-GDM mothers. Related to that, this study aims to determine breast milk production in GDM and non-GDM pregnant women. This is important so that further intervention can be carried out to prepare for breastfeeding after childbirth. The study design used a prospective cohort and involved respondents:12 pregnant women with GDM and 12 non-GDM. The inclusion criteria are GDM and non-GDM pregnant women with a gestational age of 28-31 weeks and willing to be respondents. The study was conducted at Jakarta Hospital. The instruments used are questionnaires and observation sheets for breast milk production. As for the analysis, the research used a chi-square statistical test. The results of the study showed a significant relationship between the status of GDM and non-GDM pregnant women with breast milk production ( P value 0.05). Maximum milk production in pregnant women with GDM is less than non-GDM, with a maximum amount of milk production of 0.3cc and 0.5cc, respectively. Pregnant women with GDM milk expenditure is lower than non-GDM pregnant women. Breast milk expenditure of pregnant women with GDM is slower than non-GDM pregnant women. This is evident from the research results showing that 58,3% of non-GDM pregnant women have expressed breast milk (on average starting at 17 weeks gestation). While pregnant women with GDM only as much as 8,3% have released breast milk (starting at 31 weeks of age). Breastfeeding education and breast care during pregnancy, as well as nutrition, are needed to increase maternal self-efficacy later in breastfeeding. Researchers are then expected to observe long-term breastfeeding expenditure ranging from pregnancy to six months and even up to two years of breastfeeding with many samples.

Previous High-Intensity Breastfeeding Lowers the Risk of an Abnormal Fasting Glucose in a Subsequent Pregnancy Oral Glucose Tolerance Test.

Breastfeeding is associated with reduced lifetime cardiometabolic risk, but little is known regarding the metabolic benefit in a subsequent pregnancy. The primary aim of this study was to investigate the association between breastfeeding duration and intensity and next pregnancy oral glucose tolerance test (OGTT) results. A retrospective cohort study was conducted from March 2020 to October 2022. All multiparous women who met inclusion criteria and gave birth during the study period were eligible for inclusion. Analysis was stratified by risk for gestational diabetes (GDM). High GDM risk criteria included previous GDM and BMI > 35 kg/m2. The association between breastfeeding duration and high-intensity breastfeeding (HIBF) and subsequent pregnancy OGTT were assessed with multivariate logistic models adjusted for statistically and clinically relevant covariables. There were 5374 multiparous participants who met the inclusion criteria for analysis. Of these, 61.7% had previously breastfed for >6 months, and 43.4% were at high risk for GDM. HIBF was associated with 47% reduced odds of an abnormal fasting glucose in a subsequent pregnancy OGTT (aOR 0.53; 95%CI 0.38-0.75; p < 0.01). There was no association between HIBF and other glucose results on the OGTT. Women who smoked were least likely to breastfeed at high intensity (aOR 0.31; 95%CI 0.21-0.47; p < 0.01). South Asian women had 65% higher odds of HIBF than women who identified as White/European (aOR 1.65; 1.36-2.00; p < 0.01). This study highlights the importance of exclusive breastfeeding to potentially reduce the prevalence of GDM and may also translate into long-term reduction of cardiometabolic risk.

Maternal disability and initiation and duration of breastfeeding: analysis of a Canadian cross-sectional survey

BackgroundThe World Health Organization recommends breastfeeding as the best method for infant feeding. Known risk factors for breastfeeding non-initiation and early cessation of breastfeeding are diverse and include low breastfeeding self-efficacy, poverty, smoking, obesity, and chronic illness. Although women with disabilities experience elevated rates of these risk factors, few studies have examined their breastfeeding outcomes. Our objective was to examine breastfeeding non-initiation and early cessation of breastfeeding in women with and without disabilities.MethodsWe used data from the 2017–2018 Canadian Community Health Survey. Included were n = 4,817 women aged 15–55 years who had a birth in the last five years, of whom 26.6% had a disability, ascertained using the Washington Group Short Set on Functioning. Prevalence ratios (aPR) of breastfeeding non-initiation, and of early cessation of any and exclusive breastfeeding before 6 months, were calculated for women with versus without disabilities. We also examined disability by severity (moderate/severe and mild, separately) and number of action domains impacted (≥ 2 and 1, separately). The main multivariable models were adjusted for maternal age, marital status, level of education, annual household income level, and immigrant status.ResultsThere were no differences between women with and without disabilities in breastfeeding non-initiation (9.6% vs. 8.9%; aPR 0.88, 95% CI 0.63, 1.23). Women with disabilities were more likely to have early cessation of any (44.4% vs. 35.7%) and exclusive breastfeeding before 6 months (66.9% vs. 61.3%), with some attenuation in risk after adjustment for sociodemographic factors (aRR 1.15, 95% CI 0.99, 1.33 and aRR 1.07, 95% 0.98, 1.16, respectively). Disparities were larger for women with moderate/severe disabilities and disabilities in ≥ 2 domains, with differences attenuated by adjustment for socio-demographics.ConclusionsWomen with disabilities, and particularly those with moderate/severe and multiple disabilities, could benefit from tailored, accessible breastfeeding supports that attend to the social determinants of health.